Archive for category Healthcare Financing
Missed Opportunities to Control Future Healthcare Costs in the House Healthcare Reform Bill
Posted by Mark Brenzel in For Consumers, Healthcare Financing, Healthcare Policy, Healthcare Reform on November 23rd, 2009
Missed Opportunities to Control Future Healthcare Costs in the House Healthcare Reform Bill
It is generally agreed that the recently passed House Reform Bill will cause healthcare costs to explode. Providing more people with insurance coverage and making certain services free to the patient (e.g. there will be no cost sharing for preventive services) will cause an explosion in demand. As the Massachusetts experiment has shown, the only restraint on the increase in demand will be the shortage of physicians, especially primary care physicians.
This is not to say that none of the provisions in the Bill address healthcare costs. It is worth reviewing some of these provisions.
Reducing Fraud and Abuse:
The Bill increases funding for fraud and abuse investigations. Congress learned in the 1990s after passage of the Kennedy-Kassenbaum Bill that there is potentially a lot of money to be recovered from misbehaving providers committing Medicare fraud. There have definitely been some egregious cases of fraud where providers have engaged in scams to get Medicare reimbursement for fictitious services. For the most part, however, this fraud is small dollar fraud relative to the size of the Medicare budget. The big recoveries have come from cases where the fraud was dubious at best and at worst were attacks on specific industries or companies. The actions against lab companies, home health agencies, dialysis companies, and Columbia/HCA in the 1990s and early 2000s come to mind. The accusations mostly involved different interpretations of various regulations between Medicare and the providers. In most of the cases, the government decided to go after providers for long established practices that were well known. This is not true fraud and speaks more to the complexity of Medicare’s regulations and the government’s incompetence than anything else. If the government goes after major recoveries based on “new” interpretations of what is acceptable practice, no cost reductions are being accomplished. Medicare will recover the funds, but the providers will have to seek other revenues to replace what is lost and cover the fines. As they have for 50 years, they will look to private insurers (if they are still around). This is cost shifting, not cost reduction.
Establishing Clinical Standards:
Perhaps the more interesting cost-control provision of the Bill establishes a Center for Comparative Research inside the Agency for Healthcare Research and Quality. The purpose of this new Center is “to identify the manner in which diseases, disorders, and other health conditions can most effectively and appropriately be prevented, diagnosed, treated and managed clinically” i.e. this Center will be establishing new clinical standards. For opponents of the Bill, this Center is the dreaded “Death Panel”. They fear that the Center and its related Commission inevitably would establish standards that limit care for cost reasons. However, to avoid this criticism, the following language was added to the Bill:
“Nothing in this section shall be construed to permit the Center or Commission to mandate coverage, reimbursement or other policies for public or private payers.”
“Nothing in this section shall be construed to authorize any Federal officer or employee to exercise any supervision or control over the practice of medicine.”
The Bill’s opponents can decide whether these latter two provisions provide enough security from the federal government meddling in people’s healthcare decisions. From my perspective, it is simply a missed opportunity for the government to initiate some meaningful reform. The lack of consistently applied and dynamic clinical standards is perhaps the greatest weaknesses of the healthcare system today. No other industry operates in such a manner. This lack of standards makes it impossible for insurers to adequately describe what they cover (or do not cover) and for patients to understand what they should expect from their providers. This vacuum leaves the door wide open for attorneys to sue providers and insurers for their decisions when their client did not get the desired outcome. Without standards, there is always an “expert” available to say that the care could have been better. The lack of standards also allows many medical device and pharmaceutical companies to market inferior, more expensive, and sometimes even ineffective therapies in partnership with bought off medical researchers.
While undertaking comprehensive healthcare reform, the government has a real opportunity to bring some discipline to the provision of medical services. The physician’s decision to order tests or treatments is always an exercise in probability. The current system that exposes doctors to severe malpractice risks and financially protects patients from the cost of their care leads physicians to order tests and treatments that have a low probability of providing useful information or getting effective results. Clinical standards that are developed after consideration of clinical probabilities and costs of various treatment alternatives could be very helpful to physicians. While physicians have been generally resistant to these efforts, I believe their concerns can be addressed. If the standards are tied into protection from baseless malpractice suits, physicians will be more open to the idea. The process for setting standards would have to be dynamic so that they change as new technology and information become available. They would also have to clearly indicate where physician judgment is necessary. Most importantly, insurance companies should be allowed to make coverage decisions based on these standards. Their decisions could be reviewed by an outside panel where there is disagreement. Because the standards would be based on an evaluation of probabilities, patients should always be allowed to pay for tests and treatments that are not within the standards. Research companies could also pay for “non-covered” services for their purposes.
It is absurd to think that when the government gets to the point that it is paying 60 to 70% (whether this is appropriate is another discussion) of the nation’s healthcare bill that it should not make decisions about the value of what is being purchased. It is the same discretion that any intelligent person exercises when a significant purchase is being considered. Unfortunately, the House Bill is setting up the scenario where the government will eventually pay a large percentage of the nation’s healthcare bill and have to forego a valuable tool to manage its expenditures. It is a missed opportunity.
The Patient Protection and Affordable Care Act
Posted by Editor in For Consumers, Healthcare Financing, Healthcare Policy, Healthcare Reform on November 19th, 2009
Best in Value™ Hospitals Recognized for Affordability and Efficiency
Posted by Editor in For Consumers, Healthcare Financing, Index News, Value-Based Purchasing on November 16th, 2009
Merit Award names hospitals nationwide; NY, PA & AL top the list
NASHVILLE, Tenn. –Today, Data Advantage, LLC announced the names of hospitals receiving the Best in
Value: Superior Affordability & Efficiency Merit Award™ from the 2009-2010 Hospital Value Index™, the
first and only national study on U.S. hospitals and the value of care they provide.
The Superior Affordability & Efficiency Merit Award™ showcases hospitals that deliver affordable, high
quality care to their communities with high patient satisfaction. Hospitals in economically diverse
markets, such as New York, Pennsylvania and Alabama, indicate success on all fronts and dominate this
Merit Award list. Interestingly, no hospitals from California made the list.
“The American Hospital Association recently revealed that profitability at community hospitals is
decreasing,” “Even so, hospitals like the Affordability &
Efficiency Merit Award winners are able to prevail in an economic downturn by operating their hospitals
efficiently. In doing so, this group is able to provide their patient communities with affordable
healthcare.”
“With upcoming health reform legislation and the insolvency of the Medicare trust fund in 2017,
hospitals can expect continuous pressures on reimbursement. It will be increasingly important for
hospitals to deliver high-quality care in an efficient manner,”.
The Hospital Value Index™ is an independent analysis of each hospital’s performance in the categories
of: quality, affordability & efficiency and patient satisfaction. Out of the more than 4,500 hospitals that
were analyzed, 75 received the Superior Affordability & Efficiency Merit Award for achieving high marks
in the affordability & efficiency category.
In order to receive the award, hospitals were first considered as Best in Value™, or in the top 25 percent
of all hospitals when considering quality and patient satisfaction. The top 10 percent of this group were
then recognized in the affordability & efficiency category in order to receive the Superior Affordability &
Efficiency Merit Award™.
“The Affordability & Efficiency Merit Award™ hospitals exhibit some remarkable results,” said John R.
Morrow a founder of the Hospital Value Index™ study. “These hospitals improved their scores on
average by 18.58% representing the top ten percent of all hospitals in the study, while those in the
bottom ten percent on average saw a decrease of 23.51% in their affordability and efficiency scores.”
“These improvements reflect both a reduction of costs and a decrease in prices charged for the market
basket of services. This reveals a progressive and enhanced value proposition that these hospitals
deliver to their local communities every day,” Morrow added.
In alphabetical order, the Superior Affordability and Efficiency Merit Award recipients from the 2009-
2010 Hospital Value Index™ study are:
• ACMH Hospital – Kittanning, PA
• Alle-Kiski Medical Center – Natrona Heights, PA
• Anson General Hospital – Anson, TX
• Arkansas Methodist Medical Center –Paragould, AR
• Arnot Ogden Medical Center – Elmira, NY
• Bertrand Chaffee Hospital – Springville, NY
• Billings Clinic – Billings, MT
• Bourbon Community Hospital – Paris, KY
• Bristow Medical Center – Bristow, OK
• Brooks Memorial Hospital – Dunkirk, NY
• Butler Memorial Hospital – Butler, PA
• Canton-Potsdam Hospital – Potsdam, NY
• Claxton-Hepburn Medical Center – Ogdensburg, NY
• Clifton Springs Hospital and Clinic – Clifton Springs, NY
• Community Hospital – Tallassee, AL
• Decatur General Hospital – Decatur, AL
• DuBois Regional Medical Center – DuBois, PA
• East Texas Medical Center Crockett – Crockett, TX
• Five Rivers Medical Center – Pocahontas, AR
• Gilmore Memorial Hospital – Amory, MS
• Graham Regional Medical Center – Graham, TX
• Greenbrier Valley Medical Center – Ronceverte, WV
• Hamilton General Hospital – Hamilton, TX
• Helen Keller Memorial Hospital – Sheffield, AL
• Heritage Valley Beaver – Beaver, PA
• Heritage Valley Sewickley – Sewickley, PA
• Highland Hospital – Rochester, NY
• Iberia General Hospital and Medical Center – New Iberia, LA
• Ira Davenport Memorial Hospital – Bath, NY
• Jameson Memorial Hospital – New Castle, PA
• Jamestown Hospital – Jamestown, ND
• Jellico Community Hospital – Jellico, TN
• Jennings American Legion Hospital – Jennings, LA
• Jones Memorial Hospital – Wellsville, NY
• Kenmore Mercy Hospital – Buffalo, NY
• Lakeland Community Hospital – Haleyville, AL
• Lakeside Memorial Hospital – Brockport, NY
• Livingston Regional Hospital – Livingston, TN
• Marion General Hospital – Columbia, MS
• Marshall Medical Center South – Boaz, AL
• McCullough-Hyde Memorial Hospital – Oxford, OH
• Medcenter One – Bismarck. ND
• Mercy Hospital – Buffalo, NY
• Meritcare Health System – Fargo, ND
• Minden Medical Center Inc – Minden, LA
• Monroe County Hospital – Monroeville, AL
• Morehead Memorial Hospital – Eden, NC
• Nason Hospital – Roaring Spring, PA
• Nicholas H. Noyes Memorial Hospital – Dansville, NY
• Northern Hospital of Surry County – Mount Airy, NC
• Northwest Medical Center – Winfield, AL
• Pauls Valley General Hospital – Pauls Valley, OK
• Punxsutawney Area Hospital – Punxsutawney, PA
• Roane Medical Center – Harriman, TN
• Rochester General Hospital – Rochester, NY
• Rolling Plains Memorial Hospital – Sweetwater, TX
• Southeast Alabama Medical Center – Dothan, AL
• St. Alexius Medical Center – Bismarck, ND
• St. Bernard’s Medical Center – Jonesboro, AR
• St. Clair Memorial Hospital – Pittsburgh, PA
• St. Francis Hospital – Charleston, WV
• St. Joseph’s Hospital Yonkers –Yonkers, NY
• St. Mary’s Hospital at Amsterdam – Amsterdam, NY
• St. Mary’s Medical Center of Campbell County – La Follette, TN
• Stonewall Jackson Memorial Hospital – Weston, WV
• Takoma Regional Hospital – Greeneville, TN
• Tawas St Joseph Hospital – Tawas City, MI
• Taylor Regional Hospital – Hawkinsville, GA
• Uniontown Hospital – Uniontown, PA
• Unity Hospital of Rochester – Rochester, NY
• UPMC Bedford – Everett, PA
• Weirton Medical Center – Weirton, WV
• Wheeling Hospital – Wheeling, WV
• Williamson Memorial Hospital – Williamson, WV
• Woman’s Christian Association – Jamestown, NY
For more information on the Voices of Value™ and the Best in Value™ hospitals, please visit
www.HospitalValueIndex.com.
Note: In order for hospitals to publicize results, including the use of this news release, hospitals must
obtain written approval from Data Advantage. To do so, please contact Araby Thornewill at 866-996-
3282.
Hospital Value Index™ Quality Award Recipients Released
Posted by Editor in Findings, For Consumers, Healthcare Financing, Healthcare News, Healthcare Policy, Healthcare Reform, Value-Based Purchasing on November 2nd, 2009
Superior Quality Merit Award recognizes 75 hospitals nationwide
NASHVILLE, Tenn. ‐ Data Advantage, LLC announced today 75 hospitals receiving a Best in Value™: Superior Quality Merit Award from the 2009‐2010 Hospital Value Index™ the first and only national study on U.S. hospitals and the value of care they provide.
The 2009‐2010 Hospital Value Index™is an independent analysis of each hospital’s performance in the categories of: quality, affordability & efficiency and patient satisfaction. Out of the more than 4,500 hospitals that were analyzed, 75 received the Superior Quality Merit Award for achieving high marks in the quality category.
“This group of hospitals has a proven ability to deliver high quality care, a key element in providing overall value to their communities,” “Our study suggests that hospitals that achieve outstanding scores in the area of quality will be rewarded in the new world of Value‐Based Purchasing, so each of these hospitals is off to a good start.”
The quality category is analyzed using data from the Centers for Medicare and Medicaid Services (CMS) Core Measures, AHRQ Patient Safety Indicators, CMS 30‐day mortality scores and CMS reported hospital readmission rates. In order to receive the award, hospitals were first considered as Best in Value™ or in the top 25 percent of all hospitals in the study. The top 10 percent of this group were then ranked in the quality category in order to receive the Superior Quality Merit Award.
“The Hospital Value Index™ study found that all hospitals recognized as Best in Value™ improved their quality scores by an average of 8.14% since March 2009, while those that were not recognized as Best in Value™ saw a drop in quality by 1.1% during the same term,” said John Morrow, a founder of the Hospital Value Index™ study.
“Quality continues to improve in high value hospitals, and these Merit Award recipients are being recognized for their exceptional quality performance,” Morrow added.
In alphabetical order, the Superior Quality Merit Award recipients from the 2009‐2010 Hospital Value Index™study are:
- Advocate Good Samaritan Hospital (Downers Grove, IL)
- Alegent Health Immanuel Medical Center (Omaha, NE)
- Alegent Health Lakeside Hospital (Omaha, NE)
- Alegent Health Mercy Hospital (Council Bluffs, IA)
- Alegent Health Midlands Hospital (Papillion, NE)
- Arnot Ogden Medical Center (Elmira, NY)
- Aurora Baycare Medical Center (Green Bay, WI)
- Ball Memorial Hospital (Muncie, IN)
- Baylor Medical Center at Irving (Irving, TX)
- Berger Hospital (Circleville, OH)
- Berkshire Medical Center (Pittsfield, MA)
- Bon Secours-Memorial Regional Medical (Mechanicsville, VA)
- Carolinas Medical Center‐University (Charlotte, NC)
- Centra Health (Lynchburg, VA)
- Clara Maass Medical Center (Belleville, NJ)
- Cleveland Clinic Florida (Fort Lauderdale, FL)
- Community Medical Center (Toms River, NJ)
- Cullman Regional Medical Center (Cullman, AL)
- Delray Medical Center (Delray Beach, FL)
- Evanston Hospital (Evanston, IL)
- Flowers Hospital (Dothan, AL)
- Forsyth Memorial Hospital (Winston
- Fort Madison Community Hospital (Fort Madison, IA)
- Fremont Area Medical Center (Fremont, NE)
- Gaston Memorial Hospital (Gastonia, NC)
- Good Samaritan Hospital Medical Center (West Islip, NY)
- Goshen General Hospital (Goshen, IN)
- Hackensack University Medical Center (Hackensack, NJ)
- Hackettstown Regional Medical Center (Hackettstown, NJ)
- Harlingen Medical Center (Harlingen, TX)
- Heartland Regional Medical Center (Saint Joseph, MO)
- Holland Community Hospital (Holland, MI)
- Holy Name Hospital (Teaneck, NJ)
- Huntington Beach Hospital (Huntington Beach, CA)
- Integris Mayes County Medical Center (Pryor, OK)
- Jackson Purchase Medical Center (Mayfield, KY)
- Kettering Medical Center (Dayton, OH)
- Kettering Medical Center‐Sycamore (Miamisburg, OH)
- Kingwood Medical Center (Kingwood, TX)
- La Palma Intercommunity Hospital (La Palma, CA)
- Main Line Hospital Bryn Mawr Campus (Bryn Mawr, PA)
- Mariners Hospital (Tavernier, FL)
- Meadowview Regional Medical Center (Maysville, KY)
- Memorial Hospital Pembroke (Hollywood, FL)
- Memorial Regional Hospital (Hollywood, FL)
- Mercy Medical Center‐Dubuque (Dubuque, IA)
- Mercy San Juan Medical Center (Carmichael, CA)
- Minden Medical Center (Minden, LA)
- Moberly Regional Medical Center (Moberly, MO)
- Munson Medical Center (Traverse City, MI)
- Newport Hospital (Newport, RI)
- North Ottawa Community Hospital (Grand Haven, MI)
- Oklahoma Heart Hospital (Oklahoma City, OK)
- Owatonna Hospital (Owatonna, MN)
- Parkway Medical Center (Decatur, AL)
- Peninsula Medical Center (Burlingame, CA)
- Presbyterian Hospital (Charlotte, NC)
- Presbyterian Hospital Huntersville (Huntersville, NC)
- Reid Hospital and Health Care Services (Richmond, IN)
- Saint Joseph Hospital London (London, KY)
- Saint Joseph Mercy Saline Hospital (Saline, MI)
- St. Charles Hospital (Port Jefferson, NY)
- St. Luke’s Regional Medical Center (Sioux City, IA)
- St. Mary’s Health Center (Jefferson City, MO)
- Summa Health System Barberton Hospital (Barberton, OH)
- Sutter Roseville Medical Center (Roseville, CA)
- Tawas St. Joseph Hospital (Tawas City, MI)
- Texas Health Harris Methodist Hospital Cleburne (Cleburne, TX)
- United Hospital Center (Clarksburg , WV)
- Vassar Brothers Medical Center (Poughkeepsie, NY)
- Venice Regional Medical Center (Venice, FL)
- Walker Baptist Medical Center (Jasper, AL)
- Walla Walla General Hospital (Walla Walla, WA)
- West Anaheim Medical Center (Anaheim, CA)
- Williamsport Hospital and Medical Center (Williamsport, PA)
For more information on the Voices of Value™and the Best in Value™hospitals, please visit www.HospitalValueIndex.com.
About Data Advantage, LLC
Data Advantage, LLC is a privately held healthcare information company that specializes in providing hospitals and other healthcare ‐related businesses with independent and objective business intelligence. The company has aggregated and compiled a warehouse of the most insightful information about healthcare utilization and maintains comprehensive benchmarks about the financial, operational and clinical performance of the U.S. hospital industry. For more information, visit www.data‐advantage.com or call 866‐996‐3282.
Unintended Consequences Part IV
Posted by Editor in For Consumers, Healthcare Financing, Healthcare Policy, Healthcare Reform on November 1st, 2009
Unintended Consequences Part IV
The powers of the new Healthcare Commissioner are enormous. So far, significant changes to the Medicare reimbursement system for providers have required Congressional action. If the House Bill is passed, the President will have enormous power to change how providers are reimbursed without asking Congress. The Commissioner can implement patient-centered medical homes and other care organizations, value based purchasing, bundling of services, differential payment rates, performance or utilization based payments, partial capitation, and direct contracting with providers. This power is subject to enormous abuse, which would seem almost inevitable.
The government is experiencing serious annual deficits, has a large accumulated deficit, and is facing huge deficits in the years to come. If the House Bill passes with its robust public option, the federal government could control the reimbursement rates for up to 80% of all provider claims within 10 years. One projection shows that the total cost for hospital services in 2020 could reach 1.5 trillion dollars. The government could be responsible for paying 1.2 trillion of that amount. How tempting it will be to cut hospital reimbursement and the reimbursement of other providers to decrease the government’s deficit.
However, it is not just a matter of how much of a cut hospitals may have to bear but also by what methodology they will get paid. Some of the code words above such as value-based purchasing and bundling of services should be alarming to providers. It means the government can decide winners and losers. It would appear that the government could do this on a local basis, regional basis, or even national basis.
On the local or regional level, the government could request bids from providers to provide certain services. Obviously, the first objective would be to lower the prices for those services. Hopefully, the government would also consider quality in its selection. But that would beg the question of how to measure quality. Ultimately, you can bet that politics would come into play to determine the winners and losers. Unions would try to use their clout to ensure that unionized facilities get selected. Community groups would lobby for the hospitals located in or close to their communities. Big donors to the political party in power would expect their recommendations to be considered and so on. Will hospital and doctors groups have to take on significant lobbying costs just to stay in business?
The government could also determine winners and losers on a national scale. In the 80s, hospitals and freestanding companies opened up new SNFs, psychiatric facilities, rehab facilities, and LTACs. The terrific expansion of these sub-acute units and facilities was largely a response to Medicare’s implementation of the DRG system of reimbursement for acute care services. The DRG system incented hospital discharge planners to move patients out of acute status as soon as possible and into sub-acute status where more reimbursement could be received. Initially, there was no real clinical purpose served by moving patients to these units. Many companies and hospitals invested significant capital in providing sub-acute services as volumes grew. This investment added value to their services and they are now an accepted part of the care continuum. Many hospitals converted some of their excess acute care capacity caused by the shorter length of stays to other uses. If the government decides to bundle these services into one reimbursement per patient episode, the incentive that generated growth in the sub-acute services will be turned on its head. Hospital and doctor consortiums will be the likely recipients of the bundled payments. They will want to keep as much of the funds as possible and pay outside vendors as little as possible. As a result, the average length of stays in hospitals will begin to increase and the admissions to sub-acute facilities will decrease. New capital may be needed to expand hospitals bed capacity while many sub-acute facilities are underutilized. This will be an enormous waste of resources at a time when hospitals will not have the capital resources available to them.
The House Bill encourages the Health Care Commissioner to experiment with different reimbursement models. There are an infinite number of ways to reimburse providers. Hopefully, the government will realize there are enormous consequences to changing the payment model as witnessed by the growth in sub-acute care services after the major change in the 80s. All businesses need some stability in their pricing model and volume projections to do appropriate long term planning.
The Unintended Consequences of Healthcare Reform – #1
The Unintended Consequences of Healthcare Reform – #2
The Unintended Consequences of Healthcare Reform – #3 Part 1
The Unintended Consequences of Healthcare Reform – #3 Part 2
The Unintended Consequences of Healthcare Reform – #4
The Unintended Consequences of Healthcare Reform
Posted by Mark Brenzel in For Consumers, Healthcare Financing, Healthcare Policy, Healthcare Reform on October 16th, 2009
The Unintended Consequences of Healthcare Reform
(that are never properly considered)
Two healthcare reform proposals have dominated the debate to date; the public option and how to finance the additional cost for universal coverage. However, there are some other significant changes in the House Bill that the general public would find hard to understand that would nevertheless dramatically change the healthcare system if passed.
The new Health Commissioner that will oversee the Health Choices Administration will have enormous powers over the new healthcare exchange and private QHBPs (qualified health benefit plans). The healthcare exchange will act much as the Massachusetts Connector and provide a marketplace for individuals and small employers to purchase insurance. In essence, it will allow individuals and small employers to increase their purchasing power by forcing insurers to put them into large risk pools.
Some of the requirements in the House Bill for QHBPs are as follows:
- May not consider pre-existing conditions
- Guaranteed issue and renewability
- Premium rate variability:
- Age – limited to 2-1 ratio from most expensive age group to least expensive
- By area
- By family make-up; ratio to individual premium must be consistent
- Parity in mental health and substance abuse benefits to medical benefits
- Must meet minimal medical loss ratio established by Commissioner; if does not meet it must make a refund to subscribers
- No annual or lifetime limitations
- No deductibles or co-pays for preventive services
- Limit to annual out-of-pocket expenses; $5,000 per individual, $10,000 per family
- Basic plan benefits must cover 70% of the expected cost of healthcare for the population; enhanced plan must cover 85% and premium plan must cover 95%
Some of the powers of the Health Commissioner are as follows:
- Commissioner has right to determine adequacy of network and force an insurer to pay in-network rates where their contracted network is deemed inadequate
- Commissioner can adjust premiums revenues among plans to adjust for adverse selection
- Under the public option, the provider payment mechanisms and policies may be changed from the Medicare methodology to include patient-centered medical home and other care organizations, value based purchasing, bundling of services, differential payment rates, performance or utilization based payments, partial capitation, and direct contracting with providers.
The Unintended Consequences of Healthcare Reform – #1
The Unintended Consequences of Healthcare Reform – #2
The Unintended Consequences of Healthcare Reform – #3 Part 1
The Unintended Consequences of Healthcare Reform – #3 Part 2
The Unintended Consequences of Healthcare Reform – #4
100 Top Best in Value(TM) Hospitals
Posted by Editor in Findings, For Consumers, Healthcare Financing, Healthcare News, Healthcare Policy, Healthcare Reform, Index News, Value-Based Purchasing on October 12th, 2009
Hospital Value Index: Top 100 Best in Value ™ Hospitals Released
100 Top Best in Value(TM) Hospitals
Hospitals in New York, Michigan, Pennsylvania, Alabama and North Carolina cited the most
(NASHVILLE, Tenn.) ‐ Data Advantage, LLC announced today the Top 100 Hospital: Best in Value Hospitals™ list from the 2009‐2010 Hospital Value Index™, the first and only national study on U.S. hospitals and the value of care they provide.
The hospitals in the Top 100 list represent nearly every state in the U.S. The states with the most hospitals achieving Top 100 Best in Value™ recognition were: New York, Michigan, Pennsylvania, Alabama and North Carolina.
“These are the hospitals that set the bar for the nation when it comes to value. If every hospital performed at the level of the Top 100, we found that more than $60 billion per year could be saved,”.
“The Hospital Value Index™ winners are a geographically diverse group of hospitals that have a proven ability to deliver high value care to their communities and represent a model of care that other U.S. hospitals should look to,” . “As legislators consider health reform, we believe that it will be increasingly important to recognize and reward those hospitals that deliver outstanding value.”
These results are part of the findings from the 2009‐2010 Hospital Value Index™ study, an analysis of the value of care provided at more than 4,500 U.S. hospitals. As part of the release, Data Advantage is inviting hospitals and healthcare leaders to participate in the Voices of Value™ Summit, which will take place in Chicago December 7‐9. Industry leaders will convene at the Westin Chicago River North and discuss topics such as value, affordability, efficiency and patient satisfaction.
In alphabetical order, the Top 100 list of hospitals from the 2009‐2010 Hospital Value Index™ study is:
• Alegent Health Immanuel Medical Center (Omaha, NE)
• Alegent Health Mercy Hospital (Council Bluffs, IA)
• Alegent Health Midlands Hospital (Papillion, NE)
• Alleghany Regional Hospital (Low Moor, VA)
• Arnot Ogden Medical Center (Elmira, NY)
• Berkshire Medical Center (Pittsfield, MA)
• Bertrand Chaffee Hospital (Springville, NY)
• Billings Clinic (Billings, MT)
• Bon Secours ‐Memorial Regional Medical (Mechanicsville, VA)
• Butler Memorial Hospital (Butler, PA)
• Carolinas Med Center‐Mercy (Charlotte, NC)
• Carolinas Med Center‐University (Charlotte, NC)
• Carolinas Medical Center‐Northeast (Concord, NC)
• Centra Health (Lynchburg, VA)
• Chelsea Community Hospital (Chelsea, MI)
• Citizens Medical Center (Victoria, TX)
• Clinch Valley Medical Center (Richlands, VA)
• Cobleskill Regional Hospital (Cobleskill, NY)
• Community Medical Center (Toms River, NJ)
• Connally Memorial Medical Center (Floresville, TX)
• Cullman Regional Medical Center (Cullman, AL)
• Dixie Regional Medical Center (Saint George, UT)
• Dubois Regional Medical Center (Du Bois, PA)
• Flowers Hospital (Dothan, AL)
• Forsyth Memorial Hospital (Winston Salem, NC)
• Fort Madison Community Hospital (Fort Madison, IA)
• Gaston Memorial Hospital (Gastonia, NC)
• Graham Regional Medical Center (Graham, TX)
• Greenbrier Valley Medical Center (Ronceverte, WV)
• Hamilton General Hospital (Hamilton, TX)
• Heart Hospital of Lafayette (Lafayette, LA)
• Heartland Regional Medical Center (Saint Joseph, MO)
• Henry Ford Macomb Hospital (Clinton Township, MI)
• Heritage Valley Sewickley (Sewickley, PA)
• Holland Community Hospital (Holland, MI)
• Integris Mayes County Medical Center (Pryor, OK)
• Jackson Purchase Medical Center (Mayfield, KY)
• Jefferson Regional Medical Center (Crystal City, MO)
• Kettering Medical Center (Dayton, OH)
• Kettering Medical Center –Sycamore (Miamisburg, OH)
• Lakeside Memorial Hospital (Brockport, NY)
• Lakeview Med Center (Rice Lake, WI)
• McCullough‐Hyde Memorial Hospital (Oxford, OH)
• Meadowview Regional Medical Center (Maysville, KY)
• Medical Center Enterprise (Enterprise, AL)
• Memorial Regional Hospital (Hollywood, FL)
• Mercy Health Partners Hackley Campus (Muskegon, MI)
• Mercy Health Partners‐ Mercy Campus (Muskegon, MI)
• Mercy Medical Center (Des Moines, IA)
• Mercy Medical Center‐Dubuque (Dubuque, IA)
• Methodist Medical Center of Illinois (Peoria, IL)
• Methodist Medical Center of Oak Ridge (Oak Ridge, TN)
• Minden Medical Center (Minden, LA)
• Monroe County Hospital (Monroeville, AL)
• Montgomery Regional Hospital (Blacksburg, VA)
• Mount St. Mary’s Hospital and Health Center (Lewiston, NY)
• Nebraska Heart Hospital (Lincoln, NE)
• Northwest Medical Center (Winfield, AL)
• Oklahoma Heart Hospital (Oklahoma City, OK)
• Owatonna Hospital (Owatonna, MN)
• Paradise Valley Hospital (National City, CA)
• Parkway Medical Center (Decatur, AL)
• Presbyterian Hospital Huntersville (Huntersville, NC)
• Redmond Regional Medical Center (Rome, GA)
• Reid Hospital & Health Care Services (Richmond, IN)
• Rochester General Hospital (Rochester, NY)
• Saint Joseph Hospital (London, KY)
• Saint Joseph Mercy Saline Hospital (Saline, MI)
• Saint Vincent Health Center (Erie, PA)
• Saint Vincent Hospital (Worcester, MA)
• Sarah Bush Lincoln Health Center (Mattoon, IL)
• Spectrum Health United Memorial ‐United Campus (Greenville, MI)
• St. Alexius Medical Center (Bismarck, ND)
• St. Anthony Hospital (Oklahoma City, OK)
• St. Anthony Regional Hospital (Carroll, IA)
• St. Charles Hospital (Port Jefferson, NY)
• St. Francis Health Center (Topeka, KS)
• St. Joseph Health Center (Warren, OH)
• St Josephs Hospital (Chippewa Falls, WI)
• St. Josephs Mercy Health Center (Hot Springs, AR)
• St. Luke’s Regional Medical Center (Sioux City, IA)
• St. Mary’s Health Center (Jefferson City, MO)
• St. Mary’s Hospital at Amsterdam (Amsterdam, NY)
• St. Vincent Healthcare (Billings, MT)
• Tawas St. Joseph Hospital (Tawas City, MI)
• Thomasville Medical Center (Thomasville, NC)
• Trinity Hospitals (Minot, ND)
• United Hospital Center (Clarksburg, WV)
• Unity Hospital of Rochester (Rochester, NY)
• UPMC McKeesport (McKeesport, PA)
• UPMC Northwest (Seneca, PA)
• UPMC Passavant (Pittsburgh, PA)
• Venice Regional Medical Center (Venice, FL)
• Walker Baptist Medical Center (Jasper, AL)
• Wesley Medical Center (Hattiesburg, MS)
• West Anaheim Medical Center (Anaheim, CA)
• Western Baptist Hospital (Paducah, KY)
• Wheeling Hospital (Wheeling, WV)
• White River Medical Center (Batesville, AR)
• Williamsport Hospital Medical Center (Williamsport, PA)
New Study of Best In Value™ Hospitals Highlights Potential Savings
Posted by Editor in Findings, For Consumers, Healthcare Financing, Healthcare News, Healthcare Policy, Healthcare Reform, Value-Based Purchasing on September 19th, 2009
NEW STUDY OF BEST IN VALUE™ HOSPITALS HIGHLIGHTS POTENTIAL SAVINGS OF $600B OVER 10 YEARS
Hospital Value Index™ reveals 747 hospitals leading the way in delivering affordable, quality care
Top Findings: America’s best hospital value often found in smaller towns, Midwest states
The 2009‐2010 Hospital Value Index™ ranked hospitals by an independent analysis of each hospital’s quality, affordability, efficiency and patient satisfaction performance. Out of the more than 4,500 hospitals that were analyzed, 747 were identified as providing the Best in Value™ care.
Key findings in the Hospital Value Index™ include:
• The highest value hospital care is often provided by community‐based hospitals, suggesting that consumers may find high value close to home and that policymakers should expand their search for models of reform beyond “name‐brand” teaching hospitals.
• If all hospitals in the U.S. performed at the average benchmark for the Best in Value™ hospitals, 9.3% of costs, or approximately $60B, could be eliminated from annual hospital spending on an all‐payer basis.
• The highest ranked hospitals in the study are geographically diverse, with the top 10 hospitals located in Dothan, AL; Minden, LA; Tawas City, MI; Clarksburg, WV; Gastonia, NC; Maysville, KY; Elmira, NY; Mechanicsville, VA; Holland, MI; and Winston‐Salem, NC.
• Of the 100 largest metropolitan areas in the U.S., the highest ranked markets are Charlotte, NC, Rochester, NY, Grand Rapids, MI, Pittsburgh, PA and Knoxville, TN. Markets with a population of less than 2,000,000 outperformed markets with a population of more than 2,000,000.
• There was no appreciable difference in performance between teaching hospitals and nonteaching hospitals.
• The study found that the top five states with hospitals delivering high value are North Dakota, Iowa, Montana, South Dakota, and Maine. The bottom five states for finding hospitals providing high value care are New Mexico, Arkansas, California, Hawaii and Nevada.
• The study found the gaps in hospital value can be dramatic. In one example, the study found the cost for the same medical procedure provided with the same quality of care at hospitals less than two miles apart can be more than $10,000.
The full findings of the study – and market by market rankings of hospital value performance – areavailable to the public for free at www.HospitalValueIndex.com.
Health reform
“As legislators consider health reform and as consumers shoulder an increasing burden of the cost of healthcare, it is important to recognize and reward those hospitals that deliver outstanding value,” said John Morrow, a senior advisor to Data Advantage.
“Healthcare consumers are increasingly making decisions based on value including quality, patient satisfaction and affordability. Hospitals providing the best value will ultimately be rewarded with more business.”
One of the prominent initiatives in health reform is Value‐Based Purchasing, which the Centers for Medicare and Medicaid Services (CMS) first recommended in November 2007. According to CMS, Value‐Based Purchasing will “drive improvements in clinical quality, patient‐centeredness and efficiency” in hospitals.
“The Hospital Value Index™ is the first‐ever and only benchmark to analyze these components to help hospitals understand their value proposition,” . “In Value‐Based Purchasing, hospitals will likely be reimbursed based on the overall value that they deliver, and it is essential for hospitals to understand the areas in which improvements are needed. Regardless of the ultimate scope of reform, it is clear that the future of the American economy depends upon value becoming the key determinant in purchasing healthcare.”
The Hospital Value Index™ defines a hospital’s “value” by its success in four critical areas:
Quality, including CMS’s Core Measures, patient safety, mortality and readmission rates;
• Efficiency, including the relative measure of the cost to the hospital for providing services;
• Affordability, a relative comparison of prices charged for inpatient and outpatient services, including what hospitals ultimately collect; and
• Patient satisfaction as measured by HCAHPS.
Study summit
In the study, Data Advantage found many hospitals in every state that are providing exceptional value in an increasingly demanding environment. The Best in Value™ hospitals are urban and rural; teaching and non‐teaching; for‐profit and not‐for‐profit.
“Now, more than ever, it is important to identify those hospitals that have achieved excellent results,” said Morrow. “These hospitals are the models for success under health reform.”
In order to discover the keys to delivering high value, Data Advantage will host the Voices of Value™ Summit in December, where Hospital Value Index™ leaders will discuss and share best practices in achieving and providing value in this new era.
Data Advantage will reveal more details on the Voices of Value ™ Summit in the coming weeks, and additional comments from the Voices of Value™ participants can be found below.
About Data Advantage, LLC
Data Advantage, LLC is a privately held healthcare information company that specializes in providing hospitals and other healthcare‐related businesses with independent and objective business intelligence. The company has aggregated and compiled a warehouse of the most insightful information about healthcare utilization and maintains comprehensive benchmarks about the financial, operational and clinical performance of the U.S. hospital industry. For more information, visit www.data‐advantage.com
or call 866‐996‐3282.
Voices of Value™
(full quotes are available at www.HospitalValueIndex.com)
“The HCA TriStar Health System is honored to be named among the ‘best value’ health systems in America. Our ranking is a reflection of the hard work and dedication of our staff and physicians, and our continued focus on efficiency, effectiveness, and quality outcomes.”
Larry Kloess, President
HCA TriStar Health System (Nashville, Tennessee)
“Our leadership team and staff continue to look at the way we operate our hospital in order to provide improved value, quality and service to our community. We are excited about sharing our strategies, as well as learning new practices from hospitals at the Voices of Value™ summit.”
Lloyd Ford Jr., PhD, FACHE, President and CEO
Jefferson Regional Medical Center (Festus, Missouri)
“Billings Clinic appreciates the recognition as a leader in value from Data Advantage. We are strong believers in the importance of providing quality care at an optimal cost in our current health care environment and to prepare for future changes in health care.”
Nicholas Wolter, MD, CEO
Billings Clinic (Billings, Montana)
“Parkway is honored to be named a Top 100™ Hospital. We strive to be a leader in offering outstanding ‐ high value ‐ care for our community. At Parkway, patients can expect to be treated always with compassion and professionalism and to have access to the latest medical expertise and advanced technology. It is this combination that positions us well for the future.”
Tim McGill, CEO
Parkway Medical Center (Decatur, Alabama)
“Zeeland Community Hospital is honored to receive the Best in Value™ Award. The award is an affirmation of our most sincere efforts to meet the needs of our community and exceed their expectations in terms of quality, efficiency and compassionate care.”
Henry A. Veenstra, President
Zeeland Community Hospital (Zeeland, Michigan)
“I am pleased that Saint Vincent Hospital in Worcester, Massachusetts has been recognized as one of the Top 100™ hospitals in the country in terms of the ‘value’ it provides. If health reform is to be successful at the state and federal levels, hospitals like Saint Vincent that provide the highest level of quality care at reasonable costs will lead the way.”
Joseph J Mullany, President
Vanguard Health System, New England & Chicago Market
“This achievement is truly a team effort combining the efforts of our Board, medical staff, employees, and community creating a quality health care system. St. Anthony is proud to be recognized by this award and will continue to make a caring difference every day. ”
Gary Riedmann, President
St. Anthony Regional Hospital & Nursing Home (Carroll, Iowa)
“Holy Name Hospital is honored to be ranked among the top hospitals in the country for quality, efficiency, affordability and patient satisfaction. The Best in Value™ award is distinguished by its use of published data from objective, third‐party sources. The value index isn’t anecdotal or subjective; it’s culled from a wide variety of nationally‐recognized standards, measures and indicators, and I think that’s what makes this recognition especially meaningful. One of the key tenets of our mission is stewardship, and that’s being recognized here. I am continually impressed by the way our entire team of employees, nurses and physicians comes together in a process that creates value, engendering excellence on every
level.”
Michael Maron, President/CEO
Holy Name Hospital (Teaneck, New Jersey)
“The Best in Value™ Award recognition is a testament to the great care provided at Berger Hospital. We consistently hold ourselves accountable to deliver high‐quality, cost effective healthcare, and this third party review helps to validate our success.”
Tim Colburn, CEO
Berger Hospital (Circleville, Ohio)
“At a time when the nation is focused on providing both high quality and affordable healthcare, it’s great to earn national recognition for doing just that. Consumer education is increasingly more important when making healthcare decisions. This study from an independent source verifies the value we provide our patients.”
Rosemari Davis, CEO
Willamette Valley Medical Center (McMinnville, Oregon)
“I am very pleased that we, as a team, have been recognized with this award. Our people make the difference. They are passionate, caring and down‐to earth. Whether it’s a physician, nurse, therapist or the person who works in the lab or in dietary, people make an institution great. Certainly in healthcare that’s true. Over the last 20 years this organization has done a great job of creating the infrastructure of an integrated system, which is ideally suited to successfully face challenges in health care. Our focus is entirely patient centered and we benchmark against the best of the best to constantly improve the quality care and value we are able to offer our patients.”
Mark Laney, President and CEO
Heartland Health (Saint Joseph, Missouri)
“Earning this recognition demonstrates our commitment to excellence from every part of our organization – physicians, employees, volunteers, managers and our Board of Directors.”
Edward J. Roth III, President and CEO
Aultman Hospital (Canton, Ohio)
“There is no way to really reform health care without transparency, consistent metrics and full understanding of value for money. The Hospital Value Index™ is one of the fundamental building blocks for reform that results in an accountable system and a model for engaging physicians and patients in ways that can make a real difference.”
Jonathan T. Lord, CEO
Navigenics
Community Hospitals May Provide Higher Quality, Value
Posted by Editor in For Consumers, Healthcare Financing, Healthcare News, Value-Based Purchasing on September 16th, 2009
Janice Simmons, for HealthLeaders Media, September 16, 2009
Some of the highest value hospital care actually may be provided by nearby community-based hospitals, according to the 2009-2010 Hospital Value Index released Tuesday that ranks hospitals by an analysis using publically available data on quality, affordability, efficiency, and patient satisfaction performance data……………………..
Community Hospitals May Provide Higher Quality, Value from Media Health Leaders
The Joint Committee on Taxation’s Preliminary Report on Healthcare Reform Tax Effects
Posted by Editor in Healthcare Financing, Healthcare Policy, Healthcare Reform on September 16th, 2009
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